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Query: UMLS:C0020505 (hyperphagia)
 6,116 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Sixty-six patients with locally advanced or diffuse gastrointestinal cancer or suffering from major complications due to surgery or radiation therapy, were treated with continuous parenteral hyperalimentation at the Istituto Nazionale Tumori of Milan for a cumulative period of 2101 study-days. Patients were divided into 4 groups: Group 1, malnourished patients with advanced gastrointestinal malignancy; Group 2, patients with gastrointestinal fistulae due to simple surgical complications or to radiation injury of the bowel; Group 3, patients with major postoperative complications; Group 4, surgical patients with gastric or colo-rectal carcinoma treated preoperatively. Mean infusional regime for the various groups included 42-56 Cal/kg/day and 1.5 to 2.4 g amino acid/kg/day, and the duration of the treatment ranged from 7 to 144 days. The results obtained show that protein calorie depletion of cancer patients may depend on malnutrition and that it can be reversed by parenteral nutrition, in patients, that are candidates for surgical treatment or those who qualify for chemotherapy and/or radiotherapy. Parenteral nutrition has a fundamental role in patients with fistulae, even if much attention must be paid to the external care of the fistula and the wound. In addition, nutritional support by intravenous feeding has proven essential for a successful outcome of patients with major postoperative complications. Preoperative protein repletion and central venous nutrition in patients who require gastrintestinal surgery represent a modern advance in the field of cancer surgery.
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PMID:Parenteral hyperalimentation in patients with gastrointestinal cancer. 9 80

Patients with idiopathic chronic intestinal pseudo-obstruction suffer from malnutrition because of inability to maintain adequate oral intake without the development of obstructive symptoms. We have successfully used central venous nutrition in two patients with this syndrome, both on a short-term and long-term home-maintenance basis. Hyperalimentation can provide adequate nutrition in patients with intestinal pseudo-obstruction until normal bowel function returns or until definitive therapy for this chronic disease is found.
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PMID:Idiopathic chronic intestinal pseudo-obstruction. Use of central venous nutrition. 10 Jun 20

Overt malnutrition in children with cancer is seen with surprising frequency: up to 37.5% in a group of patients with disease metastatic to or from bone, and 17.5% in a group of newly diagnosed patients with abdominal or pelvic tumors. It appears more frequent in some cancers. e.g., Ewing's sarcoma, than in others, e.g., osteosarcoma. Criteria for diagnosis of overt malnutrition are applicable to the child with cancer. Such overt malnutrition can be successfully and safely treated with intravenous hyperalimentation (IVH). Marginal malnutrition is a state that can be inferred from clinical behavior, although it cannot be objectively diagnosed as yet. Early data suggest that deterioration to overt malnutrition can be averted through IVH. Such nutritional intervention may increase chemotherapeutic tolerance and improve immune defenses. Since childhood cancer is beginning to frequently show excellent outcome, the association of malnutrition with progressive disease strongly suggests investigation of the role of nutritional support.
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PMID:Malnutrition in children with cancer: incidence and consequence. 10 83

The importance of maintaining the cancer patient's nutritional status is now recognized as a major part of the medical care. It is necessary for the oncology team to be aware of the psychological and physiological factors that interfere with food acceptance so that the correct food can be offered at the right time in the most palatable form. The oral route is the preferred method of feeding, and nutritional supplements, chosen according to the individual patient's needs, are of great value in assuring an adequate oral intake. Diagnostic tests and therapy are frequent causes of disruption of the meal schedule and the dietary service must be flexible in providing the patient an opportunity to make up for missed meals. Taste disturbance, nausea, vomiting and mucositis caused by therapy may necessitate periods of intravenous hyperalimentation. Food aversions due to therapy can frequently be prevented by avoiding new or unusual foods in the hours before chemotherapy or irradiation. Regular nutrition counseling during clinic visits and/or hospitalization permits diet modification for specific therapeutic needs. The ultimate goal is the prevention of wasting and debilitation due to malnutrition in the cancer patient.
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PMID:Oral feedings in the cancer patient. 10 86

In over 1000 cancer patients treated with intravenous hyperalimentation (IVH), tumor growth has not been identified and catheter-related sepsis has been minimal. Studies in rats demonstrated that the host benefits more than the tumor during nutritional repletion, and any stimulation of tumor growth in the rat-tumor model could be manipulated with DNA specific drugs to benefit the host. A study of 65 malnourished cancer patients undergoing oncologic therapy and treated with IVH indicated that much of the immune suppression in these patients was the result of malnutrition coincident with or secondary to oncologic treatment. Conclusions reached in this study were that nutritional repletion resulted in a return of skin test reactivity, proper wound healing in the surgical patient, and possibly an increase in response to chemotherapy. Certainly, the use of IVH allowed specific oncologic therapy to be administered to a group of malnourished patients who otherwise might not have been acceptable candidates for intensive antineoplastic therapy.
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PMID:Nutrition, cancer, and intravenous hyperalimentation. 10 87

The effect of intravenous hyperalimentation (IVH) on cell mediated immunity was examined in 22 patients. Each patient received PHA and PPD skin tests before and after the performance of IVH. In this study both PHA and PPD skin reactivity showed significant increase after IVH, and serum albumin levels had positive correlation with the PPD skin reaction changes. Absence of the established delayed hypersensitivity in the surgical patient, especially those with malignant diseases, is probably secondary to generalized malnutrition, and established cell mediated immunity can be restored by proper nutritional repletion.
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PMID:The effect of intravenous hyperalimentation on cell mediated immunity. 10 91

This paper represents an extensive review, spanning 30 years of experience with 404 patients with gastrointestinal fistulas. It includes the first period (1945-1960) during the introduction of antibiotics, the second period (1960-1970) which saw rapid improvements in parasurgical care including, respiratory support, perfection of antibiotics, some introduction of nutritional support and improved monitoring, and the third period which saw the introduction of parenteral nutrition specifically central venous hyperalimentation using hypertonic glucose and amino acids (1970-1975) in the treatment of patients with fistulas. The principal causes for mortality in the historical sense were malnutrition, sepsis and electrolyte imbalance. Mortality among patients with gastrointestinal cutaneous fistulas decreased between the first and second periods from approximately 48 to 15%. Surprisingly, mortality did not decrease further in the "hyperalimentation period" although spontaneous closure of gastrointestinal fistulase increased. The results suggest that the improvement in mortality in patients with gastrointestinal cutaneous fistulas is mostly due to the introduction of improved parasurgical care. It is acknowledged that nutritional support was practiced in the 1960's although this was generally not in the form of hyperalimentation. The addition of hyperalimentation in large scale to the treatment of gastrointestinal cutaneous fistulas has improved spontaneous closure and is a valuable part of the armamentarium. The decrease in mortality however, cannot be attributed to parenteral nutrition.
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PMID:Review of 404 patients with gastrointestinal fistulas. Impact of parenteral nutrition. 11 38

Head and neck cancer patients present with special problems in nutritional homoeostasis because of local phayngeal discomfort and obstruction and difficulty with deglutition due to either the neoplasm or the surgical alterations in the upper aerodigestive tract. Pretreatment malnutrition and vitamin deficiency are only compounded by the nutritional stress imposed by radiation and surgery. Reduced wound complications occur if the patients are nutritionally replenished before treatment. While nasogastric feedings will suffice in many patients, rapid nutritional restoration by this method is limited, and positive nitrogen balance may be difficult to achieve in the severely malnourished patient. Intravenous hyperalimentation offers a rapid and efficacious alternative in selected cases. The case histories of two patients are presented to illustrate these concepts.
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PMID:Enteral and parenteral nutrition in patients with head and neck cancer. 11 4

Cancer cachexia should no longer be a contraindication to adequate antineoplastic treatment. Current methods of nutritional assessment allow one to identify malnutrition and to follow the nutritional status of the patient throughout the cancer-management program. Enteral nutritional repletion and maintenance remain the ideal course of action, but the gastrointestinal tract is not always readily available or advisable for use; in such circumstances, intravenous hyperalimentation (IVH) may be indicated. The properly nourished patient better tolerates cancer therapy, experiences fewer complications of malnutrition (e.g., sepsis and poor wound healing), and has a better-functioning immune system than does his malnourished counterpart. This article reviews methods of nutritional assessment, delineates indications and techniques for nutritional repletion, and summarizes the results obtained.
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PMID:Nutritional concepts in the treatment of head and neck malignancies. 11 11

A high-output gastrointestinal fistula is a surgical catastrophe of the first order of magnitude. Previously associated with an extraordinarily high mortality, the advent of parentaeral nutrition has markedly altered the management of these fistulas. Malnutrition and electrolyte imbalance formerly were the causes of death in the majority of patients. At the present time the mortality rate has decreased from approximately 40-60% to 6-20%, depending on the series. a suggested plan of therapy for high-output gastrointestinal fistulas is outlined. Good local care, sump drainage and nutritional support with or without the use of appropriate antibiotics, depending on the circumstances, are the keystones of management. Radiologic definition of the fistula is of primary importance. Certain criteria by which one may predict fistula closure aare outlined. The emphasis in this chapter is on an attempt at spontaneous closure with parenteral nutrition. In the event that this in not achieved, complete exclusion of the fistula from the gastrointestinal tract, either by excision or by total bypass, is mandatory to achieve satisfactory results. Causes of death remain sepsis and peritonitis related to the fistula, but an occasional patient will succumb to massive bleeding. Catheter-related sepsis and complications of hyperalimentation are largely preventable, and steps to prevent such complications are outlined.
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PMID:The management of high-output intestinal fistulas. 12 23


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